William Wallace Faulk, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10777 Issued in GA

Practice address

4510 Augusta Rd
Garden City, GA 31408-1750

Phone

(912) 964-1030

Fax

(912) 964-8412

NPI assigned

Mar 21, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730205758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7503",
            "city": "GARDEN CITY",
            "state": "GA",
            "postal_code": "314187503",
            "telephone_number": "912-964-1030",
            "fax_number": "912-964-8412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 AUGUSTA RD",
            "city": "GARDEN CITY",
            "state": "GA",
            "postal_code": "314081750",
            "telephone_number": "912-964-1030",
            "fax_number": "912-964-8412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAULK",
        "first_name": "WILLIAM",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "10777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Katherine Stefania Guadamud, RDN, LDN
• Nakiea Jovan Hampton
• Anna Hendershot, RPH

• All providers in Garden City, GA
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.